Abstract
Background
After receiving a living donor liver transplant (LDLT), an incisional hernia is a potentially serious complication that can affect the patient’s quality of life. In the present study we evaluated surgical hernia repair after LDLT.
Materials and methods
Medical records of patients who underwent surgery to repair an incisional hernia after LDLT in Turgut Ozal Medical Center between October 2006 and January 2010 were evaluated in this retrospective study. A reverse-T incision was made for liver transplantation. The hernias were repaired with onlay polypropylene mesh. Age, gender, post-transplant relaparatomy, the type, the result of surgery for the incisional hernia, and risk factors for developing incisional hernia were evaluated.
Results
An incisional hernia developed in 44 of 173 (25.4 %) patients after LDLT. Incisional hernia repair was performed in 14 of 173 patients (8.1 %) who underwent LDLT from October 2006 to January 2010. Relaparatomy was associated with incisional hernia (p = 0.0002). The mean age at the time of the incisional hernia repair was 51 years, and 79 % of the patients were men. The median follow-up period was 19.2 (13–36) months after the hernia repair. Three patients with intestinal incarceration underwent emergency surgery to repair the hernia. Partial small bowel resection was required in one patient. Postoperative complications included seroma formation in one patient and wound infection in another. There was no recurrence of hernia during the follow-up period.
Conclusions
The incidence of incisional hernia after LDLT was 25.4 % in this study. Relaparatomy increases the probability of developing incisional hernia in recipients of LDLT. According to the results of the study, repair of an incisional hernia with onlay mesh is a suitable option.
Similar content being viewed by others
References
Jeon H, Lee SG (2010) Living donor liver transplantation. Curr Opin Organ Transpl 15:283–287
Porrett PM, Hsu J, Shaked A (2009) Late surgical complications following liver transplantation. Liver Transpl 15(Suppl 2):S12–S18
Kahn J, Müller H, Iberer F et al (2007) Incisional hernia following liver transplantation: incidence and predisposing factors. Clin Transplant 21:423–426
Vardanian AJ, Farmer DG, Ghobrial RM et al (2006) Incisional hernia after liver transplantation. J Am Coll Surg 203:421
Janssen H, Lange R, Erhard J et al (2002) Causative factors, surgical treatment and outcome of incisional hernia after liver transplantation. Br J Surg 89:1049
Perkins JD (2007) Incisional hernia following liver transplantation: today’s incidence and causes of this pesky problem. Liver Transpl 13:1339
Shi LW, Verran D, Rao AR et al (2003) Incisional hernia following orthotopic liver transplantation. Transpl Proc 35:425
Gomez R, Hidalgo M, Marques E et al (2001) Incidence and predisposing factors for incisional hernia in patients with liver transplantation. Hernia 5:172
Piazzese E, Montalti R, Beltempo P et al (2004) Incidence, predisposing factors and results of surgical treatment of incisional hernia after liver transplantation. Transpl Proc 36:3097
Piardi T, Audet M, Panaro F et al (2010) Incisional hernia repair after liver transplantation: role of the mesh. Transpl Proc 42:1244–1247
Heistercamp J, Marsman HA, Eker H et al (2008) A J-shaped subcostal incision reduces the incidence of abdominal wall complications in liver transplantation. Liver Transpl 14:1655–1658
Müller V, Lehner M, Klein P et al (2003) Incisional hernia repair after orthotopic liver transplantation: a technique employing an inlay/onlay polypropylene mesh. Langenbecks Arch Surg 388:167–173
DuBay DA, Wang X, Adamson B et al (2006) Mesh incisional herniorrhaphy increases abdominal wall elastic properties: a mechanisms for decreased hernia recurrence in comparison with suture repair. Surgery 140:14
Mekeel K, Mulligan D, Reddy KS et al (2007) Laparoscopic incisional hernia repair after liver transplantation. Liver Transpl 13:1576–1581
Kurmann A, Beldi G, Vorberger SA et al (2010) Laparoscopic incisional hernia repair is feasible and safe after liver transplantation. Surg Endosc 24:1451–1455
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ozgor, D., Dirican, A., Ates, M. et al. Incisional Hernia in Recipients of Adult to Adult Living Donor Liver Transplantation. World J Surg 38, 2122–2125 (2014). https://doi.org/10.1007/s00268-014-2528-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-014-2528-9